Jason Owen Wallin, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3838 Issued in MN

Practice address

4717 Hiawatha Ave
Minneapolis, MN 55406-3928

Phone

(612) 721-2146

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jason O. Wallin Chiropractic, PA

  • Chiropractor
  • Minneapolis, MN
  • NPI 1184998510
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679628309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4717 HIAWATHA AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063928",
            "telephone_number": "612-721-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 HIAWATHA AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063928",
            "telephone_number": "612-721-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "JASON",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55F56BL",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simone Wallace
• Thomas K Wallace, CRNA
• Willie Wallace
• Jeff Wallager
• Nancy Waller, M.D.
• Wallingburg Home Care Services
• Elizabeth Joan Wallner, PT
• Caitlin Maurine Walseth
• David Alan Walsh, PH.D.
• Jocelyn Walsh, CCC-SLP, M.ED.

• Chiropractor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.